摘要
目的研究ICU感染性休克病死危险因素及相应的临床对策,为临床治疗提供依据。方法回顾性分析医院ICU收治的感染性休克患者84例,采用单因素和多因素logistic回归对死亡危险因素进行分析。结果 84例感染性休克患者中,49例死亡,病死率58.3%;单因素分析结果显示,死亡组与存活组患者在年龄(52.6±11.9)岁与(43.3±12.7)岁、APACHEⅡ评分(23.1±5.7)与(18.6±4.8)分、血液感染67.3%与40.0%、SIRS数目3.3±0.7与1.5±0.7、MODS数目4.2±1.6与1.9±0.8、24h尿量(3.4±2.1)与(6.2±2.5)ml、平均动脉压(43.7±9.6)与(56.7±11.4)mm Hg及白蛋白(24.6±7.1)与(29.4±8.5)g/L 8个因素差异有统计学意义(P<0.05);多因素非条件logistic回归分析显示,APACHEⅡ评分(OR=0.47)、SIRS数目(OR=1.71)、MODS数目(OR=2.47)及白蛋白(OR=1.44)是感染性休克死亡的独立危险因素(P<0.05)。结论积极调控炎症反应,在去除病因的基础上进行综合治疗,可降低ICU感染性休克的病死率。
OBJECTIVE To investigate the risk factors for the infectious septic shock in the ICU patients so as to put forward the corresponding countermeasures so as to provide basis for the clinical treatnent. METHODS A total of 84 patients with septic shock who were treated in the ICU were retrospectively analyzed, the univariate analysis and logistic regression analysis were performed to observe the risk factors. RESULTS Among 84 patients, 49 patients died, the mortality was 58.3 %. Univariate analysis showed that there was statistical difference in the age （52.6±11.9 vs. 43.3±12.7）, APACHEⅡ score （23.1±5.7 vs. 18.6±4.8）, blood infections（67.3% vs. 40.0%）, numbers of SIRS（3.3±0. 7vs. 1.5±0.7） and MODS （4.2±1.6 vs. 1.9±0.8）, 24h urine output （3.4±2.1 vs. 6.2±2.5 ml）, mean artery pressure（43.74±9.6 vs. 56.7±11.4 mm Hg） and albumin（24.64±7.1 vs. 29.44±8.5 g/l） between the survival group and the death group（P〈0. 05）. Multivariate logistic regression analysis showed that the APACHEⅡ score （OR=0.47）, numbers of SIRS（OR=1. 71） ,and MODS （OR=2.47） and albumin （OR= 1.44） were independent risk factors for the death caused by septic shock. CONCLUSION It is effective to reduce the mortality caused by the infectious septic shock in ICU through the positive control of inflammation and comprehensive treatment on the basis of removing the basic causes.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第1期30-32,共3页
Chinese Journal of Nosocomiology
